Individual provider Active NPI

Raghavendra V Ghuge, MD

  • Sleep Medicine (Internal Medicine) Physician
  • Tyler, TX
National Provider Identifier
1891768461
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
License
K0769 Issued in TX
Practice address
3187 Paluxy Dr
Tyler, TX 75701-8303
Phone
(903) 787-7533
Fax
(903) 787-8825
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) Physician 207RS0012X K0769 TX Primary

Addresses

Primary practice location

3187 Paluxy Dr
Tyler, TX 75701-8303

Mailing address

PO Box 8270
Tyler, TX 75711-8270
Phone (903) 787-7533

Other identifiers 1

IdentifierTypeStateIssuer
031565702MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040806000120 TX Practitioner - Sleep MedicinePractitioner - Internal Medicine 5597737098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sleep MedicineAlso: Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3187 Paluxy Dr
Tyler, TX 75701-8303
Phone (903) 787-7533

Merit-based Incentive Payment System (MIPS)

Final score
73.4 of 100Reported as individual
Quality
46.8
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K0769TXMDSleep Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Medicine Institute of Texas, PA Sleep Medicine CurrentSince Dec 27, 2010 Accepting new patients

Locations

115 W 5th St
Ste 200
Tyler, TX 75701
Phone (903) 787-7533

3187 Paluxy Dr
Tyler, TX 75701
Phone (903) 787-7533

Interoperability endpoints

  • Direct secure messaging: raghavendraghuge@smitpa.allscriptsdirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/JGDHDD/Endpoint/JGDHDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/JGDHDD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1891768461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8270",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757118270",
            "telephone_number": "903-787-7533",
            "fax_number": "903-787-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3187 PALUXY DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018303",
            "telephone_number": "903-787-7533",
            "fax_number": "903-787-8825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHUGE",
        "first_name": "RAGHAVENDRA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "TX",
            "license": "K0769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031565702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.